Abstract:

BACKGROUND: The posterior approach for axillary nerve by brachial triceps branches of radial nerve transfer produces excessive retraction of the deltoid muscle and may result in the injury to the posterior branch of the axillary nerve and supraclavicular brachial plexus, it required to change the location when explore and joint other nerve transfer. 
OBJECTIVE: To investigate the anatomical feasibility of transferring the brachial triceps branches of radial nerve to anterior branch of axillary through an axillary access in repairing axillary nerve.
METHODS: The axillary nerve was bilaterally dissected in 10 embalmed cadavers by conventional formaldehyde to study its variations. Dissection was performed through an axillary exposure with the supine, arm abducted and externally rotated and axillary access. All the nerves and vessels in the axilla were performed with microdissection. The distance from originating point to branch and transverse diameter of the anterior branch of axillary nerve were observed and measured. The transverse diameter of the anterior branch of the brachial triceps and the length of untraumatic detachment of brachial triceps branches of radial nerve were observed and measured.
RESULTS AND CONCLUSION: At the lateral margin of the subscapularis muscle, the axillary nerve was divided into an anterior and a posterior branch. The anterior branch diameter averaged 2.5 mm (range 1.6-3.4 mm). The triceps long head motor branch diameter averaged 2.2 mm (range 1.4-2.8 mm). The average distance between axillary nerve and radial nerve was 18.2 mm (range 10.2-30.0 mm). The diameter of triceps brachii branches of radial nerve was similar to the anterior branch of axillary nerves and the distance was short. It indicates that axillary access can expose and identify the anterior and posterior branch of axillary nerve. The axillary nerve can be repaired by triceps motor nerve transfer as the expression of brachial triceps branches of radial nerve on the surface of latissimus dorsi tendon was close to axillary nerve.